Interstitial brachytherapy for lip carcinomas: Comparison between Ir-192 low-dose-rate and high-dose-rate treatment

IF 1.5 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie Pub Date : 2024-04-01 DOI:10.1016/j.canrad.2023.06.031

M. Cuenin , J. Salleron , D. Peiffert , É. Meknaci , P. Gallet , Y. Abushama , J.-F. Py , S. Renard

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Abstract

Purpose

Low-dose-rate (LDR) and high-dose-rate (HDR) interstitial brachytherapy are known to be effective in the treatment of lip carcinomas. The aim of this study was to retrospectively compare oncologic and toxicity outcomes between the two techniques.

Patients and methods

From 2007 to 2018, patients at the Institut de cancérologie de Lorraine (France) who received exclusive or adjuvant interstitial brachytherapy for lip squamous carcinomas were studied. Two groups were defined: the LDR/PDR group, including patients treated with iridium-192 wires, or pulsed-dose rate technique, and the high-dose-rate group, with patients treated by high-dose-rate technique. The dose ranged between 50 Gy and 65 Gy (depending on previous surgery) for low-dose-/pulsed-dose rate treatments, and 39 Gy for high-dose-rate (twice a day). Early, late toxicity events and oncologic control were reported.

Results

Among the 61 patients whose data were analyzed retrospectively, 36 received the low-dose-/pulsed-dose rate treatment (59%) and 25 the high-dose-rate brachytherapy (41%). The median follow-up time was 44 months. At 36 months, the local control rates were 96.3% for LDR/PDR group and 100% for HDR (P = 0.180). The regional control rates were 85.9% and 92% without any difference according to the two groups (P = 0.179). The specific overall survival rate was 95.5% with no difference between groups. There were more grade 2 or higher mucositis in the HDR group than in LDR/PDR group (40% versus 16.7%, P = 0.042). One case of grade 3 mucositis was recorded in each group. No grade 3 late complications were recorded. High-dose-rate brachytherapy reduced the length of hospitalization by 2 days (P < 0.001).

Conclusion

High-dose- or low-dose-/pulsed-dose rate brachytherapy seemed to be as effective and well tolerated in our experience of 61 patients.

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治疗唇癌的间质近距离放射治疗：Ir-192低剂量治疗与高剂量率治疗的比较

目的众所周知，低剂量率（LDR）和高剂量率（HDR）间质近距离放射治疗可有效治疗唇癌。这项研究的目的是回顾性比较两种技术的肿瘤学和毒性结果。患者和方法从2007年到2018年，研究人员对法国洛林癌症研究所（Institut de cancérologie de Lorraine）接受专治或辅助性间质近距离治疗唇鳞癌的患者进行了研究。研究分为两组：LDR/PDR 组，包括接受铱-192 线或脉冲剂量率技术治疗的患者；高剂量率组，包括接受高剂量率技术治疗的患者。低剂量/脉冲剂量率治疗的剂量介于 50 Gy 和 65 Gy 之间（取决于之前的手术），高剂量率治疗（每天两次）的剂量为 39 Gy。结果在对数据进行回顾性分析的 61 例患者中，36 例接受了低剂量/脉冲剂量率治疗（59%），25 例接受了高剂量率近距离放射治疗（41%）。中位随访时间为 44 个月。36 个月时，LDR/PDR 组的局部控制率为 96.3%，HDR 组为 100%（P = 0.180）。两组的区域控制率分别为 85.9% 和 92%，无差异（P = 0.179）。总生存率为 95.5%，组间无差异。与LDR/PDR组相比，HDR组出现2级或2级以上粘膜炎的比例更高（40%对16.7%，P = 0.042）。每组均有一例 3 级粘膜炎病例。无 3 级晚期并发症记录。高剂量率近距离放射治疗使住院时间缩短了 2 天（P < 0.001）。结论在我们对 61 例患者的治疗经验中，高剂量率或低剂量/脉冲剂量率近距离放射治疗似乎同样有效且耐受性良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Radiotherapie 医学-核医学

CiteScore

2.20

自引率

23.10%

发文量

129

审稿时长

63 days

期刊介绍： Cancer/radiothérapie se veut d''abord et avant tout un organe francophone de publication des travaux de recherche en radiothérapie. La revue a pour objectif de diffuser les informations majeures sur les travaux de recherche en cancérologie et tout ce qui touche de près ou de loin au traitement du cancer par les radiations : technologie, radiophysique, radiobiologie et radiothérapie clinique.